A simplified approach for fixed rehabilitation of the atrophic maxillae

This study describes the 1-11 years follow up of 15 patients treated with dental implants in the atrophic posterior maxilla without the need for a sinus augmentation procedure. Objective:To examine the long term function of an alternative mode of treatment for fixed rehabilitation of the atrophic posterior maxilla. Methods:15 patients with severly resorbed edentulous posterior maxilla were treated with dental implants and fixed prosthesis.All patients were initially considered candidates for sinus augmentation procedures to facilitate the placement of implants because of lack of bone height .By anterior-palatal angulation of the most posterior implant,a fixed prosthesis could be made without the need for cantilever prosthesis.31 implants were placed.2 implants were connected to teeth,5 patients needed horizontal bone augmentation .The following periodontal parameters were checked:probing depth,bleeding on probing,bone level. Results:No implants were lost,the periodontal parameters and bone level were within the norm,and at the end of the observation period all patients had stable fixed prosthesis. Discussion:Traditionally,sinus augmentation procedure is mandatory for a fixed rehabilitation of the atrophic maxilla.The augmentation procedure enables the use of long ,parallel ,prosthesis oriented implants which support a fixed restoration.However,the sinus augmentation procedure is not suitable for some patients because of their age,medical or financial status.The proposed treatment approach is simple with low morbidity and the possible complications are the same as any implant treatment. Conclusion:bone oriented implant placement can be considered a safe and predictable alternative for fixed rehabilitation of the atrophic posterior maxilla for patients not able or not willing to undergo sinus lift procedure